HIP Fracture Accelerated Surgical TreaTment And Care tracK (HIP ATTACK) Trial

NCT02027896 | Completed DMC

• 1 other identifier: HIP ATTACK Trial v5.0
• Study Type: interventional
• Target: 3,001
• Locations: 17 countries
• Sites: 69

Brief Summary

HIP ATTACK is an international randomized controlled trial of 3000 patients with a hip fracture that requires a surgical intervention. This trial will determine the effect of accelerated medical clearance and accelerated surgery compared to standard care on the 90-day risk of mortality and major perioperative complication (i.e., a composite of mortality, nonfatal myocardial infarction, nonfatal pulmonary embolism, nonfatal pneumonia, nonfatal sepsis, nonfatal stroke, and nonfatal life-threatening and major bleeding).

Conditions

Hip Fractures

Keywords

Perioperative outcomes

Outcome Measures

Primary Outcomes (2)

• Composite - major perioperative complication

  Composite of mortality, nonfatal myocardial infarction, nonfatal pulmonary embolism, nonfatal pneumonia, nonfatal sepsis, nonfatal stroke, and nonfatal life-threatening and major bleeding

  90 days

• Mortality

  All-cause mortality

  90 days

Secondary Outcomes (40)

• All-cause mortality

  90 days and 1 year

• Vascular mortality

  90 days and 1 year

• Non-vascular mortality

  90 days and 1 year

• Myocardial infarction

  90 days and 1 year

• Cardiac revascularization procedure

  90 days and 1 year

Study Arms (2)

Accelerated medical clearance and surgery

EXPERIMENTAL

Rapid medical clearance with targeted arrival to the operating room within 6 hours of diagnosis of a hip fracture requiring surgical repair.

Other: Accelerated medical clearance and surgery

Standard surgical care

NO INTERVENTION

Surgical hip fracture repair according to the standard timing.

Interventions

Accelerated medical clearance and surgery OTHER

Rapid medical clearance with targeted arrival to the operating room within 6 hours of diagnosis of a hip fracture requiring surgical repair.

Accelerated medical clearance and surgery

Eligibility Criteria

• Age: 45 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• age ≥45 years; and
• diagnosis of hip fracture during working hours with a low-energy mechanism (i.e., falling from standing height) requiring surgery.

You may not qualify if:

• patients requiring emergent surgery or emergent interventions for another reason (e.g., subdural hematoma, abdominal pathology requiring urgent laparotomy, acute limb ischemia, other fractures or trauma requiring emergent surgery, necrotising fasciitis, coronary revascularization, pacemaker-implantation);
• open hip fracture;
• bilateral hip fractures;
• peri-prosthetic fracture;
• therapeutic anticoagulation not induced by a Vitamin K Antagonist, unfractionated heparin, (e.g., administration of therapeutic Low Molecular Weight Heparin (LMWH) (\>6,000 u/24h) in the 24 hours prior to enrolment, or intake of any other non-reversible oral anticoagulant(s) for which there is no reversing agent available
• patients on a therapeutic vitamin K antagonist with a history of heparin induced thrombocytopenia (HIT);
• patients refusing participation; or
• patients previously enrolled in the study.

Sponsors & Collaborators

• McMaster University: lead
• Population Health Research Institute: collaborator
• Hamilton Health Sciences Corporation: collaborator

Study Sites (69)

Regional Medical Center of San Jose

San Jose, California, United States

Location

University of Maryland

Baltimore, Maryland, 20742, United States

Location

Lahey Hospital and Medical Centre

Burlington, Massachusetts, 01805, United States

Location

Tufts Medical Centre

Washington, Massachusetts, 02111, United States

Location

Ohio State University Medical Centre

Columbus, Ohio, 43210, United States

Location

Cliniques Universitaires Saint-Luc

Brussels, Belgium

Location

Cliniques Universitaires Saint-Luc

Woluwe-Saint-Lambert, Belgium

Location

South Health Campus

Calgary, Alberta, Canada

Location

University of Alberta Hospital

Edmonton, Alberta, Canada

Location

Vancouver General Hospital

Vancouver, British Columbia, Canada

Location

Concordia Hip and Knee Institute

Winnipeg, Manitoba, MB R2K 2M9, Canada

Location

QEII Health Sciences

Halifax, Nova Scotia, B3H 3A7, Canada

Location

Royal Victoria Hospital

Barrie, Ontario, Canada

Location

Etobicoke General Hospital

Etobicoke, Ontario, Canada

Location

St. Joseph's Hospital Hamilton

Hamilton, Ontario, L8N 4A6, Canada

Location

Hamilton Health Sciences - Juravinski Hospital

Hamilton, Ontario, L8V 5C2, Canada

Location

Kingston General Hospital

Kingston, Ontario, K7L 2V7, Canada

Location

Grand River Hospital

Kitchener, Ontario, Canada

Location

Victoria Hospital, London Health Sciences

London, Ontario, Canada

Location

Markham Stouffville Hospital

Markham, Ontario, Canada

Location

Ottawa General Hospital

Ottawa, Ontario, K1H 8L6, Canada

Location

Thunder Bay Regional Health Sciences Centre

Thunder Bay, Ontario, P7B 6V4, Canada

Location

Humber River Hospital

Toronto, Ontario, M3M 0B2, Canada

Location

St. Michael's Hospital

Toronto, Ontario, Canada

Location

Sunnybrook Health Sciences Centre

Toronto, Ontario, Canada

Location

Beijing Chaoyang Hospital

Beijing, China

Location

Fundacion Cardioinfantil

Bogotá, 13B-60, Colombia

Location

Centre Hospitalier Lyon Sud

Lyon, France

Location

Nimes University Hospital

Nîmes, 30029, France

Location

Queen Mary Hospital

High West, Hong Kong

Location

Government TD Medical College

Alappuzha, 688005, India

Location

Sparsh Hospital

Bangalore, 560099, India

Location

PGIMER

Chandigarh, India

Location

Bangalore Baptist Hospital

Hebbāl, 560024, India

Location

NH Kolkata

Kolkata, 700099, India

Location

CMC Ludhiana

Ludhiana, 141008, India

Location

Seven Star Hospital

Nagpur, India

Location

AIIMS Hospital

New Delhi, India

Location

JIPMER

Puducherry, India

Location

Sancheti Institute for Orthopaedics and Rehabilitation

Shivājīnagar, 411005, India

Location

Government Medical Hospital

Trivandrum, India

Location

Ospedale San Raffaele

Milan, 20132, Italy

Location

Humanitas Research Hospital

Milan, Italy

Location

IRCCS Galeazzi Orthopedic Institute

Milan, Italy

Location

ASST Sette Laghi - Ospedale Di

Varese, Italy

Location

Hospital Pulau Pinang

George Town, Malaysia

Location

University Malaya Medical Centre (UMMC)

Kuala Lumpur, 59100, Malaysia

Location

Deventer Ziekenhuis

Deventer, Netherlands

Location

Shifa International Hospitals

Islamabad, 44000, Pakistan

Location

The Aga Khan University

Karachi, 74800, Pakistan

Location

SPZOZ Szpital Powiatowy w Bochni im M. Wieckiej

Bochnia, Poland

Location

University Hospital & Educational Center of Medical University in Lodz

Lodz, Poland

Location

Samodzielny Publiczny Zakład Opieki Zdrowotnej W Myślenicach

Myślenice, 32-400, Poland

Location

Groote Schuur Hospital

Cape Town, 7925, South Africa

Location

Stellenbosch University

Cape Town, South Africa

Location

Chris Hani Baragwanath Hospital

Johannesburg, 2193, South Africa

Location

Hospital San Pau

Barcelona, 08025, Spain

Location

Hospital Universitaire Vall d'Hebron

Barcelona, 08035, Spain

Location

Corporació Sanitària Parc Taulí

Barcelona, 08208, Spain

Location

Mutua de Terrassa Hospital

Barcelona, 08221, Spain

Location

Hospital Sant Camil (Consorci Sanitari Garraf)

Barcelona, Spain

Location

Costa del Sol

Marbella, 29603, Spain

Location

Hospital Clinico Universitario de Vallad

Valladolid, Spain

Location

Ramathibodi Hospital

Bangkok, 10400, Thailand

Location

Calderdale & Huddersfield NHS

Huddersfield, United Kingdom

Location

Chelsea and Westminster Hospital

London, SW10 9NH, United Kingdom

Location

West Middlesex Hospital

London, United Kingdom

Location

Peterborough City Hospital

Peterborough, United Kingdom

Location

King's Mill Hospital

Sutton in Ashfield, NG17 4JL, United Kingdom

Location

Related Publications (4)

• Khan JS, Mulazzani F, Devereaux PJ, Bhandari M, Guerra-Farfan E, Patel A, Shanthanna H, Slobogean G, Sigamani A, Umer M, Feibel RJ, Tiboni ME, Tandon V, Harvey V, Balasubramanian K, Vincent J, Tonelli AC, Gilron I, Torrie AM, Borges FK; HIP ATTACK Investigators. Pain as a Driver of Myocardial Injury in Hip Fracture Patients: A Hip Fracture Accelerated Surgical Treatment and Care Track (HIP ATTACK) Trial Secondary Analysis. Anesthesiology. 2026 Feb 1;144(2):289-300. doi: 10.1097/ALN.0000000000005818. Epub 2025 Oct 27.

  PMID: 41147656 DERIVED

• HIP ATTACK Investigators. Accelerated surgery versus standard care in hip fracture (HIP ATTACK): an international, randomised, controlled trial. Lancet. 2020 Feb 29;395(10225):698-708. doi: 10.1016/S0140-6736(20)30058-1. Epub 2020 Feb 9.

  PMID: 32050090 DERIVED

• Borges FK, Devereaux PJ, Cuerden M, Bhandari M, Guerra-Farfan E, Patel A, Sigamani A, Umer M, Neary J, Tiboni M, Tandon V, Ramokgopa MT, Sancheti P, John B, Lawendy A, Balaguer-Castro M, Jenkinson R, Sleczka P, Nabi Nur A, Wood GCA, Feibel R, McMahon JS, Sigamani A, Biccard BM, Landoni G, Szczeklik W, Wang CY, Tomas-Hernandez J, Abraham V, Vincent J, Harvey V, Pettit S, Sontrop J, Garg AX; HIP ATTACK investigators. Effects of accelerated versus standard care surgery on the risk of acute kidney injury in patients with a hip fracture: a substudy protocol of the hip fracture Accelerated surgical TreaTment And Care tracK (HIP ATTACK) international randomised controlled trial. BMJ Open. 2019 Sep 24;9(9):e033150. doi: 10.1136/bmjopen-2019-033150.

  PMID: 31551393 DERIVED

• Borges FK, Bhandari M, Patel A, Avram V, Guerra-Farfan E, Sigamani A, Umer M, Tiboni M, Adili A, Neary J, Tandon V, Sancheti PK, Lawendy A, Jenkinson R, Ramokgopa M, Biccard BM, Szczeklik W, Wang CY, Landoni G, Forget P, Popova E, Wood G, Nabi Nur A, John B, Sleczka P, Feibel RJ, Balaguer-Castro M, Deheshi B, Winemaker M, de Beer J, Kolesar R, Teixidor-Serra J, Tomas-Hernandez J, McGillion M, Shanthanna H, Moppett I, Vincent J, Pettit S, Harvey V, Gauthier L, Alvarado K, Devereaux PJ. Rationale and design of the HIP fracture Accelerated surgical TreaTment And Care tracK (HIP ATTACK) Trial: a protocol for an international randomised controlled trial evaluating early surgery for hip fracture patients. BMJ Open. 2019 May 1;9(4):e028537. doi: 10.1136/bmjopen-2018-028537.

  PMID: 31048449 DERIVED

Related Links

• HIP ATTACK Pilot Canadian Medical Association Journal (CMAJ) Publication

MeSH Terms

Conditions

Hip Fractures

Interventions

Surgical Procedures, Operative

Condition Hierarchy (Ancestors)

Femoral Fractures; Fractures, Bone; Wounds and Injuries; Hip Injuries; Leg Injuries

Study Officials

• Philip J Devereaux, MD, PhD

  McMaster University

  PRINCIPAL INVESTIGATOR

• Mohit Bhandari, MD, PhD

  McMaster University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: January 2, 2014
• First Posted: January 6, 2014
• Study Start: March 14, 2014
• Primary Completion: August 24, 2019
• Study Completion: September 30, 2022
• Last Updated: January 22, 2024

Record last verified: 2024-01

Locations

CO (1); IT (4); BE (2); HK (1); MY (2); FR (2); NL (1); US (5); ES (7); CA (18); TH (1); GB (5); IN (11); PL (3); ZA (3); CN (1); PA (2)